Tiromel introduction not going well - is that ok?

[bunnycalledpedro]

Hi there. I posted my medicheck results a few weeks back and the concensus was that i should slowly introduce a low dose of t3 due to me not being a great converter of t4 to t3. I ordered and started tiromel (25mcg) 4 days ago on a dose of a quarter of a tablet twice a day. I felt the strong effects after an hour and realised after taking 2 lots that the starting dose should have been a quarter of a tablet per day split into 2 doses. I adjusted for the second day. I have had side effects of a menstrual bleed (2 weeks early) extreme tiredness and dizziness (more than usual) and a fuzzy head all within the first 24hrs. I was worried and so on day 3 did not take any. Last night I took an eigth of a tablet and feel unwell today -

My question is - is this ok and common and something that will settle down within a week or so, or should I just stop taking them entirely? (I am hoping that it is ok as I was so hopeful that they would make me feel better!) Many thanks in advance to anyone who takes the time to respond.

[RockyPath]

Did you begin by cutting back on the levothyroxine?

If you're suspecting you're not converting, the first thing you would do, if you were to follow clinical studies of replacement with T3, is cut back on the LT4 by 50 mcg. Then you add the T3 a little at a time. In studies, they typically replaced 50 mcg LT4 with 10 to 12.5 of T3.

If you're unaccustomed to taking T3, the 1/4 tablet (about 6 mcg) is a good start for several days, up to a week. You have to watch and take note of your heart rate after dosing -- check on hourly intervals to learn how your body is reacting. The T3 will raise your rate. I noticed it was especially dramatic when I added T3 on top of the regular dose of improperly-converted levothyroxine. I spent a day on the bed unable to move, but all was better within 18 hours.

Your body will need a week or so to adapt to changes each time in the T3 you are taking, so don't make changes any faster than five days, and pay attention to your resting heart rate. Write everything down, with the date and time of taking the T3, plus resting pulse.

Too much T3 will feel the same on your body as too little, so this is why you make tiny dose changes. I was impatient and made bigger changes too frequently and it has been like threading a needle in the dark while wearing gloves.

Good luck.

[bunnycalledpedro in reply to RockyPath]

Hi Rockypath, thank you so much for your reply, this has really scared me!! I cut down my t4 by 25mcg for a week, so following your advice, I think I will cut down a bit more and hold off on the t3 for another week and try again. Thank you, your advice has reassured me

[RockyPath in reply to bunnycalledpedro]

You don't have to hold off on the T3 once you cut back on the levothyroixine. If you're not converting, and you do cut back on the levo, adding the first bit of T3 will give you some instant gratification.

[Judithdalston]

I started Tiromel on even smaller dose of 1/8 th of a pill and was amazed that my hips unstiffened in hours( also have fibromyalgia)..so like you found it a powerful ‘med’. I also developed fast pulse and palpitations for first month while I slowly got up to the full 25 mcg pill, then they disappeared. Did you reduce your levo. dose by the 25 mcg as suggested? I removed 50 mcg of levo to be ‘replaced’ by the 25 mcg T3 only to find after a further 6 weeks that my FT3 had in fact gone down further. Unfortunately everyone is so different in how they respond to adding T3, and it can take months( years) to get the right balance with combo, or T3 only. You may find keeping a ‘diary’ of symptoms, bp, pulse, basal temp. plus vit/ min blood results helpful, and remember once you add T3 ‘traditional’ FT4 and TSH results decline, often below ranges( which is ok), and only FT3 may be relevant. I have gone onto taking T3 only, and conscious it can be low levels of vit D, b12, folate and ferritin that can hinder health improvements, and yours might still be low. Patience, resist the start/ stop with T3( it doesn’t work like the longer half-life T4). You can experiment with dosing when you take the T3: in one dose with levo. for eg, or split into 2 even 3 doses thruout the day; I take mine in middle of the night. But remember to use like levo.well away from food/ drink/ supplements other meds. ...I found that splitting into 3 doses was too difficult when taking supplements too and finding appropriate gaps/time to eat and drink!

[bunnycalledpedro in reply to Judithdalston]

Hi Judith, Thank you for your reply. I reduced my Levo by 25mcg a week before starting with t3 and I think I will stick to one eighth of a tablet (hard to split precisely!) once a day in the evening and see how I go. I will start to keep a diary too. Like you I take so many other supplements through the day, I have lots of alarms set on my phone!

Best wishes

[bunnycalledpedro]

Hi there, I was on 141mcg per day (150 day one and two and 125 day three) and I have reduced (11 days ago) to 125mcg. Small changes in t4 have a big impact on me, but I may drop this down further after a full week on t3. I am going to start a diary too, to track the changes. It's all trial and error I guess!!